(Musings on Life as a Mom and a Vet)

On Human Docs and Vets

My mother in law is currently in the hospital being treated for complications of having hyperthyroidism. Or is it just the hyperthyroidism itself? Nobody seems to know.

I’m going to go out on a limb and make some generalizations here. I find human medicine to be an infuriating quagmire of excess, inefficiency, and a complete disregard for good old-fashioned intuition.

As vets, we’re trained to look at the whole, entire patient. We don’t get the apparent human luxury of picking a problem, then happily pronouncing that “oops…not my jurisdiction…goto the specialist for that problem”. What happens (it seems to me) that specialists are great for when you have one problem, but what happens when you have a whole bunch of them? Then you (seem) to have a whole bunch of specialists and none of them talk to each other, so nothing seems to get done. Everybody thinks somebody else is handling the issue. If they aren’t, that’s ok, just send in another specialist and things will be A-OK.

Vets, on the other hand, have to BE those specialists for the most part because a) most clients won’t be thrilled about schlepping their pets all over town and b) most clients have a finite amount they will spend figuring out all of their pets issues. Not to say we don’t use specialists, but we handle the vast majority of cases in-house and refer the hard stuff. This gives us, in my opinion, the opportunity to take all the relevant info on the patient, consolidate it and try to work through their issues in a coherent way. It’s a balanced approach to patient care. We know we have to balance the heart problem and the kidney problem and don’t have to worry that the heart guy is going to screw up what the kidney guy told us to do or that the kidney guys treatment just negated what the heart guy did.

Maybe it isn’t really this bad in human hospitals, but it seems that way at the moment.

My mother in law, as I said, has hyperthyroidism. We see this all the time in older cats. The thyroid gland puts out thyroid hormone, which controls your metabolism. There are benign tumors in the thyroid gland that produce too much thyroid hormone, which subsequently raises the metabolism to a frantic pace.

Frankly, the only good thing about this (for a human) is it’s like hitting the weight loss lottery. You lose weight like crazy and can eat all you want. Your body just burns off all the calories. The down side is your heart is pumping out of your chest because all that thyroid hormone is telling it to, and it will eventually wear out and fail.

People generally bring their cats in for weight loss, they (the cats, and usually the humans too, actually) usually act pretty normal. Apparently in humans, the symptoms are pretty variable, as a result of actual toxicity from all that hormone floating around. My mother in law had insomnia, profound muscle weakness , anorexia, dehydration, etc. The disease seems to make humans pretty darn sick.

The treatment for humans and animals is exactly the same. You can take a pill to inhibit thyroid production and/or you can take some radioactive iodine which gets picked up by the overactive thyroid cells, and collected into a nice radioactive bundle that zaps the bad cells and kills them.

Here’s where I’m going out on a limb, because I’m not a human doc. Based on my research on a human doctor website that I got access too by certifying that I was an “other” type of Doctor: there is a phenomenon called a “Thyroid storm” (sidebar…that is a GREAT name for a disease…love it…but love storms…and Storm the X-men character…but I digress) anyhow, it can be triggered by the I131 (radioactive iodine) treatment .

Best as I can figure based on what I skimmed in the article, the injured thyroid gland goes nuts and shoots out vast quantities of hormone. Triggering a bunch of other hormones which ultimately can make patients really, really sick, if not kill them.

Based on what I read in the article, the symptoms looked pretty close to what my mother in law was experiencing. I called the family, rallied the troops and created mayhem and discord about her treatment and care! Grandma’s getting worse and we don’t know why! Human docs don’t seem to communicate much with their clients or clients families. They seem to go about their business and you hear snippets about what’s going on.

The closest thing to a vet that I have found in the human med field is the family practitioner. They know a little about everything, and I have, what is, in my opinion: a great family practitioner. She respects that I’m a medical professional and treats me like an equal (unlike the pediatrician who laughed at me during his interview when I mentioned that being a vet was like being a pediatrician). She’s fabulous at taking her time and explaining to me whatever is going on with myself or my family. Yah, I go to visits at her office with books, entertainment for the kids in hand because the visit could take a while, but even if I’m fuming when she comes in, I always calm down because she’s so good at her job.

She’s super smart and can handle just about anything, but when she can’t she refers me to the requisite specialist or consults with one. She’s got a great bedside manner (and takes good care of her dogs as she’s subsequently become my client too).

Anyhow, I called her with my hypothesis and she got on the phone and started reeling in all the disparate stories we were getting from the various specialists, nurses, and docs working on my mother in law.

Turns out, I was wrong, the m.i.l. is not suffering from a thyroid storm. Which is probably a good thing because imagine the kind of ego I’d develop if I became an excellent self-trained quasi-human doctor (although in times of national emergencies I can practice medicine on humans…which I think is super cool: e-collars for everyone!).

Mother in law is just super, duper, ooper dehydrated and hopefully will be ok once they straighten out all her issues.

It just seems like human medicine is just soooo tangled and convoluted. I guess I need to remember that when I get all bogged down in how amorphous and vague vet med can be.

At least I don’t have to deal with somebodys mom or grandma in the hospital with excitable Cuban daughter in law veterinarians questioning me at every turn. Geez. How annoying.

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One thought on “On Human Docs and Vets”

Dr. C – again another great post. I laughed out loud with the idea of 211 million US citizens of varying sizes in e-collars. Imagine if e-collars could capture all of the negative things people think and do. We’d only have to deal with our own stuff.